CT增强扫描同轴穿刺活检在肺部肿瘤性病变中的应用研究

发布时间：2018-02-15 04:10

  本文关键词： CT引导 肺癌 CT增强 同轴穿刺活检 肺占位 气胸　出处：《北华大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨CT增强扫描同轴穿刺活检在肺部肿瘤诊断中的临床应用价值。方法:选取94例肺部肿瘤性病变的门诊或住院病人,将其随机分为对照组与研究组,对照组43例,实验组51例,采用螺旋CT引导下经皮穿刺肺部占位性病变,对照组采用CT平扫定位,研究组采用CT增强定位,均应用同轴穿刺活检,对比两组平均活检次数、穿刺取材满意率、病理回报阳性率、肺恶性肿瘤检出率以及并发症(出血、气胸、感染、气体栓塞)发生的几率,比较两种定位引导方法的影像学价值。结果:1.对照组患者43例活检次数51次,其中6名患者进行二次活检,2名患者进行三次活检,取材满意率达74.42%;研究组患者51例活检次数53次,其中2名患者进行二次活检,取材满意率达90.20%。研究组与对照组平均活检次数比较、取材满意率比较(P0.05)差异有统计学意义。2.对照组患者43例,32例获得阳性结果,病理阳性率为58.14%,恶性病灶检出率51.16%,其中鳞癌1例,腺癌13例,神经内分泌肿瘤1例,非小细胞癌4例,恶性胸膜间皮瘤1例,转移瘤2例,错构瘤1例,神经鞘瘤1例,硬化性血管瘤1例。研究组患者51例46例获得阳性结果,病理阳性率为80.39%,恶性病灶检出率74.51%,其中鳞癌2例,腺鳞癌3例,腺癌21例,大细胞癌1例,神经内分泌肿瘤1例,小细胞肺癌1例,非小细胞癌6例,转移瘤2例,恶性胸膜间皮瘤1例,嗜酸性肉芽肿1例,结核2例。研究组与对照组病理阳性率比较、恶性肿瘤检出率比较(P0.05)差异有统计学意义。3.对照组43例患者经CT平扫扫同轴穿刺活检,有24例出现并发症,其中气胸21例(48.84%),出血19例(44.17%);研究组51例患者出现并发症21例(41.18%),其中气胸17例(33.33%),出血11例(21.57%)。两组各有2例患者肺压缩体积大于30%,胸闷憋气明显,均给予闭式引流后痊愈;对照组1例患者出现肋间动脉损伤出血,行介入栓塞止血。其余气胸、出血患者未给予特殊处理,72小时后检查均完全吸收。两组均无术后感染及气体栓塞病例。术后出现穿刺部位疼痛5人,其中对照组3人,研究组2人,给予双氯芬酸钠缓释片止痛,疼痛48-72小时后均消失。两组均未出现胸膜反应并发症。研究组与对照组并发症发生率比较(P0.05)差异有统计学意义。结论:CT增强扫描同轴穿刺活检术对肺部肿瘤性病变诊断具有重要的临床应用价值,与常规CT平扫穿刺活检术比较:平均穿刺次数减少,取材满意率增加15.78%,病理阳性率增加22.25%,恶性肿瘤检出率增加23.35%,并发症发生率减少14.63%。
[Abstract]:Objective: To investigate the CT enhanced scan coaxial biopsy in the diagnosis of lung cancer in clinical application. Methods: 94 cases of lung tumors in outpatient or inpatient, they were randomly divided into control group and study group, 43 cases in the control group, 51 cases in the experimental group, using spiral CT guided percutaneous puncture lung lesions, the control group using CT scan positioning, the study group using the enhanced CT positioning, both the application of coaxial biopsy, compared two groups of average times of puncture biopsy, the satisfactory rate of return, the pathological positive rate of malignant lung tumor detection rate and complications (bleeding, pneumothorax, infection, air embolism) occurred the probability value, comparison of two kinds of imaging guided method. Results: 1. patients with biopsy in 43 cases of the control group for 51 times, of which 6 patients underwent the two biopsy, 2 patients underwent the three biopsy specimens, the satisfaction rate was 74.42%; 51 cases of study group were treated once biopsy 鏁，

本文编号：1512393